REPUBLIC OF THE PHILIPPINES)

BACOLOD CITY, NEGROS OCCIDENTAL) S.S.

AFFIDAVIT OF CHILD CUSTODY

I, Arlene Pardillo Tacloban, Filipino, married, and a resident of Purok Acacia, Brgy. Pahanocoy,
Bacolod City, Negros Occidental, after being sworn in accordance with law, hereby depose and
state that:

1. I am the mother of one minor child named Carl Matthew Pardillo, aged 8 years-old;
2.
3. I am separated in fact from my husband, Martin Tabingo Tacloban, nor am I living with
him;

4. I exercise sole parental authority over the abovementioned child and I am the one solely
responsible for their support;

5. The abovementioned child is currently living with me at my residence;

6. I have inadequate financial means with which to support him since my livelihood has
been adversely affected by the ongoing quarantine; and

7. I execute this Affidavit to attest to the truth of the foregoing facts.

In witness whereof, I execute this Affidavit at Bacolod City, Negros Occidental this 29th day of
April 2020 to attest to the truth of the foregoing.

_____________________

Affiant

REPUBLIC OF THE PHILIPPINES)

BACOLOD CITY, NEGROS OCCIDENTAL) S.S.

SUBSCRIBED and SWORN TO before me at Bacolod City, Negros Occidental this 29th day of
April, the Affiant being known to me personally.

WITNESS MY HAND AND SEAL.

Doc. No. ________

Page No. ________
Book No. ________
Series of 2020